How Does Medicare, Social Security, and Long Term Care Work Together?

Many seniors will want to plan for the possibility of needing long-term care. Medicare does not cover long-term care, which means your Social Security payments will need to be spent toward your long-term care costs. Long-term care can be expensive, so saving up and considering additional help from a long-term care policy will help you to afford the care you need when you need it without liquidating your assets.

Medicare and Long Term Care

One of the big gaps in Medicare is its lack of coverage for long term care. Medicare Part A offers coverage for inpatient care received in a skilled nursing facility or nursing home but does not cover custodial care. Long-term care, or custodial care, is when you receive assistance in a skilled nursing facility or nursing home with the activities of daily living (ADLs) and sometimes instrumental activities of daily living (IADLs). 

Activities of daily living are often used as a measure of how functional you are and how capable you are of performing basic essential tasks. These tasks can include personal hygiene, bathing, using the restroom, getting dressed, feeding yourself, and moving from place to place. People who need help with three or more of these tasks are good candidates for long term care. 

Many home health services can assist you with the instrumental activities of daily living, which may include companionship and mental support, transportation, shopping, preparing meals, managing and cleaning up after the household, managing medications, and managing finances. These are also support services you can receive help with from a quality long term care community.

Social Security and Long Term Care

Social Security provides support for aging people. The money you receive from monthly benefit payments can be used toward any expenses you want. Benefits are used for long term care so commonly that the programs sometimes assume that you will use them that way.

Many people sell their homes when they transition to living in a long term care facility, both because they no longer need to maintain the household and because the liquidation of that asset will help them afford the costs of long term care.

Long Term Care Costs

Private care in a nursing home costs an average of $290 each day, adding up to around $8,800 per month. If you receive care in a semi-private room, your care will cost a bit less at around $255 per day or $7,700 each month in 2021.

Nursing homes provide care around the clock. People often have their rehabilitation in a nursing home after a major injury, but you can also receive skilled nursing care on a permanent basis if needed.

Your costs in a nursing home or other long-term care facility will depend on which state you live in along with your care considerations, the length of your stay, which provider you go with, and a number of other rate factors.

If your income is low enough, you may qualify for a Medicaid program, which can help cover your long-term care costs.
If you’d like to learn more about Medicare and how it works with other programs, call Texas Medicare Advisors at 512-614-2333.